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JUNE 2009 | ISSUE 141<br />

A PUBLICATION OF THE WORLD <strong>YWCA</strong><br />

feature:<br />

<strong>Let</strong>’s <strong>talk</strong> <strong>about</strong> SEX<br />

Young women on the move:<br />

What does <strong>sex</strong>ual and reproductive health<br />

and rights mean to you?<br />

hiv and aids:<br />

Forced and coerced sterilisation of HIV-<br />

Positive Women: A Human Rights Issue


CC 2<br />

Contents<br />

03 | Editorial<br />

04 | <strong>YWCA</strong>s Around the <strong>World</strong><br />

In this briefing, we highlight the work<br />

<strong>YWCA</strong>s are doing to ensure women’s<br />

<strong>sex</strong>ual and reproductive health and rights.<br />

18 | Sexual Exploitation and Violence<br />

Against Women<br />

Breaking the Poto Mitan of Haitian Society<br />

HIV and aids<br />

19<br />

Forced and coerced<br />

sterilisation of HIV-Positive<br />

Women: A Human Rights Issue<br />

Guaranteeing women’s human right to<br />

free and informed reproductive healthcare<br />

decision-making<br />

Feature<br />

6<strong>Let</strong>’s <strong>talk</strong> <strong>about</strong><br />

SEX<br />

Ensuring women’s human right to<br />

healthy <strong>sex</strong>ual and reproductive lives<br />

Take Action<br />

11 | Looking through the cross at<br />

violence against women<br />

12 | Pregnancy Matters<br />

Maternal mortality and the human rights<br />

of women<br />

Young Women on the Move<br />

14 | What does <strong>sex</strong>ual and reproductive<br />

health and rights mean to you?<br />

Leading Change<br />

16 | Higher education, higher risks<br />

<strong>YWCA</strong> of Ethiopia responds to university<br />

women’s <strong>sex</strong>ual and reproductive health<br />

needs<br />

Briefing<br />

21 | From the <strong>World</strong> <strong>YWCA</strong><br />

23 | People<br />

23 | Supporters<br />

President: Susan Brennan General Secretary: Nyaradzayi<br />

Gumbonzvanda Editor: Kaburo Kobia Co-ordinators: Sarah<br />

Davies, Sylvie Jacquat Distribution: Fiona Wilkie. Articles may be<br />

freely reproduced with acknowledgement to <strong>World</strong> <strong>YWCA</strong> Common<br />

Concern ISSN 1025-4099. All artwork, images and photography<br />

is protected by copyright and may not be reproduced without<br />

permission. ©2009 <strong>World</strong> <strong>YWCA</strong>.<br />

Common Concern is published in French and Spanish, contact<br />

worldoffice@worldywca.org to order.<br />

On the Cover: Moo Moo Hsoe<br />

<strong>World</strong> <strong>YWCA</strong> Intern 2009 and Assistant<br />

programme Secretary at the <strong>YWCA</strong> of Myanmar.<br />

www.worldywca.org


CC 3<br />

Editorial<br />

Daily, the world is confronted<br />

with staggering statistics<br />

related to women’s health:<br />

an unacceptable number<br />

of girl-child marriages, women dying in<br />

childbirth and young women exposed<br />

to <strong>sex</strong>ually transmitted infections and<br />

HIV. In many countries women and girls<br />

face violence and abuse resulting in<br />

gross violations of their human rights.<br />

Female genital cutting or mutilation,<br />

honour killings, forced sterilisations,<br />

criminalisation of HIV transmission all<br />

speak to the daily horrors many women<br />

face condoned by culture, customs,<br />

misapplication of religious norms and<br />

legislation.<br />

The <strong>World</strong> <strong>YWCA</strong> has, in the last<br />

decade, intensified its interventions,<br />

programmes and activities around<br />

HIV prevention and care. It is now<br />

evident that such interventions remain<br />

incomplete unless framed in a way<br />

that equally respond to <strong>sex</strong>ual and<br />

reproductive health and rights of<br />

women and young people. Violence<br />

against women is the ultimate<br />

manifestation of women’s lack of<br />

access to their rights. In February<br />

2009, the <strong>YWCA</strong> held a consultation<br />

on <strong>sex</strong>ual reproductive health and<br />

rights (SRHR) with a number of<br />

member associations and partners<br />

who collectively defined an approach<br />

for the <strong>YWCA</strong> movement to adopt. The<br />

proposed strategy guides the <strong>YWCA</strong><br />

in creating change in our communities<br />

and addressing laws and norms<br />

related to the triple challenge of<br />

<strong>sex</strong>ual and reproductive health and<br />

rights, HIV and violence against<br />

women (VAW).<br />

With the revised approach,<br />

the <strong>World</strong> <strong>YWCA</strong> is focusing<br />

on comprehensive prevention,<br />

comprehensive support and care<br />

within safe spaces for women and<br />

girls and a commitment to building<br />

evidence through documentation,<br />

monitoring and evaluation.<br />

The series of regional training<br />

institutes on SRHR, HIV and VAW that<br />

the <strong>YWCA</strong> movement is hosting in the<br />

next two years attest to our investment<br />

in a coherent global response<br />

while equipping individual women<br />

leaders with skills and tools to deliver<br />

at the local level and within their<br />

communities.<br />

While the <strong>World</strong> <strong>YWCA</strong> makes<br />

its own contributions, the movement<br />

continues to ask for accountability<br />

and commitment towards actions<br />

that invest in women and girls,<br />

uphold their human rights and<br />

end stigma and discrimination.<br />

The International Conference of<br />

Population and Development (ICPD)<br />

held in Cairo in 1994 concluded with<br />

pledges to achieve universal access<br />

to reproductive health services for<br />

every one in all countries by 2015.<br />

The Millennium Development Goals<br />

echo the ICPD goals and call for<br />

a specific commitment to reduce<br />

maternal mortality by 2015. Next year,<br />

the world will review the commitment<br />

government leaders made in the<br />

2001 Declaration of Commitment<br />

on HIV and AIDS. As advocates for<br />

women’s health, we must not only hold<br />

our leaders accountable for these<br />

promises, but also find ways to ensure<br />

they are achieved.<br />

In this issue of Common Concern<br />

we explore what SRHR means<br />

and how member associations,<br />

women leaders and civil society<br />

can contribute to a safe world free<br />

of violence and free of HIV where<br />

women’s reproductive health and<br />

rights are respected. •<br />

Nyaradzayi Gumbonzvanda<br />

General Secretary, <strong>World</strong> <strong>YWCA</strong><br />

www.worldywca.org


CC 4<br />

<strong>YWCA</strong>s Around<br />

the <strong>World</strong><br />

Since 1855, <strong>YWCA</strong>s around the world have championed women’s rights. <strong>YWCA</strong>s work<br />

within their local context to find solutions that work for the women and girls in their community.<br />

In this briefing, we highlight the work <strong>YWCA</strong>s are doing to ensure women’s <strong>sex</strong>ual<br />

and reproductive health and rights.<br />

Over 200 young women took an active part in the <strong>YWCA</strong> of Ukraine trainings on <strong>sex</strong>ual and reproductive health and rights.<br />

Young women in Ukraine learn <strong>about</strong><br />

responsible <strong>sex</strong>ual behaviour<br />

Ukraine has the highest number of people living<br />

with HIV in Europe. In response, the <strong>YWCA</strong><br />

of Ukraine has organised workshops in the<br />

capital Kyiv that educate young women on<br />

HIV and AIDS. Over 250 young women have attended the<br />

workshops and learnt <strong>about</strong> responsible <strong>sex</strong>ual behaviour,<br />

the importance of good <strong>sex</strong>ual health and the social and<br />

economic factors that make women vulnerable to HIV. “I did<br />

not even know female condoms exist. We have so much to<br />

learn and we must tell other people,” said a young woman<br />

participant.<br />

“The young women take themselves more seriously with<br />

respect to their health,” says Marina Grodzitskaya, Project<br />

Manager for the workshops, “They obtain information on<br />

where and how they can undergo anonymous HIV testing<br />

and if necessary get consultations and support. They<br />

become aware of the dangers of unprotected <strong>sex</strong>.“<br />

The workshops are popular with young women who<br />

are eager for information on HIV and <strong>sex</strong>ual health. “This<br />

training gave me a new push to act. I have started to deliver<br />

mini-trainings to my friends,“ says Christine, a <strong>YWCA</strong><br />

member.<br />

The <strong>YWCA</strong> of Ukraine will continue hosting the<br />

workshops and hopes to expand the participation to <strong>sex</strong><br />

workers.<br />

www.worldywca.org


YwCAs Around the <strong>World</strong><br />

CC 5<br />

The <strong>YWCA</strong> of Grenada hosted an HIV awareness booth<br />

and voluntary testing at the Grenada Sailing Festival.<br />

Finding support after breast cancer<br />

Going sailing? Take a condom<br />

Globally, breast cancer kills one woman every<br />

75 seconds. The <strong>YWCA</strong> Encore programme,<br />

run by <strong>YWCA</strong>s in New Zealand, Australia, USA,<br />

Canada and Japan, assists women who have<br />

had breast cancer surgery. Encore was developed in the<br />

1970s by <strong>YWCA</strong> USA women who had experienced trouble<br />

finding appropriate support programmes after breast<br />

cancer surgery.<br />

Recovering from breast cancer can have serious<br />

physical and psychological effects. Encore has been<br />

designed to address the challenges of recovery through<br />

improving mobility and flexibility, boosting self-esteem and<br />

confidence and finding relief from discomfort experienced<br />

after surgery. Encore is offered free-of-charge and runs<br />

over an eight-week period with a weekly group meeting to<br />

participate in floor and pool exercises and an information<br />

and support session.<br />

In Australia, Encore evaluations found nine out of ten<br />

women who attend an Encore course report physical<br />

improvement. Eight out of ten women feel an increase in<br />

their energy level and 100 per cent of the women report that<br />

they benefited from attending Encore.<br />

The <strong>YWCA</strong> of Grenada has pledged their<br />

commitment to raise awareness of HIV and <strong>sex</strong>ual<br />

and reproductive health rights (SRHR) on the<br />

Caribbean island of Grenada.<br />

The association has developed an HIV and AIDS<br />

Committee that works alongside the Grenada National Aids<br />

Directorate and other non-governmental organisations to<br />

educate both its membership and the general public on HIV<br />

and AIDS and SRHR.<br />

The <strong>YWCA</strong> of Grenada recently hosted an HIV<br />

awareness booth and voluntary counseling and testing<br />

at the Grenada Sailing Festival. “It was an excellent<br />

opportunity to showcase Grenada’s HIV agenda. <strong>YWCA</strong><br />

volunteers walked along the beach with educational<br />

materials that included posters, male and female condoms,<br />

contact cards and an HIV awareness survey,“ says Shonta<br />

Duncan, a <strong>YWCA</strong> of Grenada member.<br />

Promotional materials such as water bottles were<br />

handed out to people who correctly answered questions<br />

on the topic. Condoms were also distributed to those who<br />

attended to encourage responsible <strong>sex</strong>ual practices and<br />

behaviour. The association also held an Open House on<br />

<strong>World</strong> AIDS Day 2008 to raise awareness of HIV in Grenada<br />

and provide information on the correct use of the male and<br />

female condom.<br />

www.worldywca.org


CC 6<br />

feature<br />

<strong>Let</strong>’s <strong>talk</strong> <strong>about</strong><br />

www.worldywca.org


feature<br />

CC 7<br />

The International Conference<br />

on Population and<br />

Development (ICPD) held<br />

in Cairo in 1994, hosted by<br />

the United Nations, brought together<br />

governments, inter-governmental<br />

agencies, world leaders, civil society<br />

and activists to discuss the link<br />

between population and development,<br />

specifically women’s role in alleviating<br />

poverty. During the conference, it was<br />

made clear that until women and girls<br />

have full enjoyment of their rights, in<br />

family life and society, the development<br />

of communities and countries would be<br />

held back. The conference concluded<br />

with a Programme of Action (PoA) that<br />

outlined key areas for governments<br />

and world leaders to address in<br />

order to ensure women and girls can<br />

live full and fulfilling lives. The goals<br />

include commitments on increasing<br />

access to education for women and<br />

girls, reducing child and maternal<br />

mortality and ensuring women’s<br />

health, especially their <strong>sex</strong>ual and<br />

reproductive health.<br />

The ICPD set a target for the<br />

PoA—governments are to achieve the<br />

goals by 2015. With less than five years<br />

to go, the world is far from reaching the<br />

ambitious goals set in the PoA. Women<br />

still die needlessly from childbirth<br />

complications, young women lag<br />

behind their male peers in education<br />

and far too many girls entering their<br />

reproductive years face numerous<br />

dangers from violence to HIV, early<br />

marriage to risk of cervical and breast<br />

cancer.<br />

Reproductive health and<br />

rights<br />

The outcomes of the ICPD offer<br />

the most comprehensive definitions of<br />

<strong>sex</strong>ual and reproductive health and<br />

rights (SRHR). Although some theories<br />

on SRHR remain contentious, the<br />

definitions set at the ICPD have gone<br />

on to inform the work of countless<br />

organisations, including the <strong>World</strong><br />

<strong>YWCA</strong>.<br />

In 2003, the <strong>World</strong> <strong>YWCA</strong> Council<br />

adopted a resolution on Reproductive<br />

Health and Sexuality calling on the<br />

<strong>YWCA</strong> movement to promote and work<br />

towards the provision of extensive<br />

access to quality education, resources,<br />

information, discussion and counseling<br />

for women and girls regarding their<br />

reproductive rights.<br />

Many <strong>YWCA</strong>s have implemented<br />

programmes on reproductive health<br />

like the acclaimed <strong>YWCA</strong> Encore<br />

Breast Cancer programmes available<br />

across the USA, Australia, New<br />

Zealand and Japan that provide women<br />

with support as they recover from<br />

breast cancer surgery.<br />

In Ghana, the <strong>YWCA</strong> run<br />

reproductive health services that<br />

reached over 60,000 schoolgirls and<br />

women of reproductive-age through<br />

mobile health clinics funded by the<br />

Centre for Development and Population<br />

Activities (Cedpa).<br />

Violence, HIV and the link<br />

to <strong>sex</strong>ual rights<br />

Sexual rights protect women and<br />

men’s right to decide when, where,<br />

how and with whom they choose to<br />

have <strong>sex</strong>ual experiences. Furthermore,<br />

people—including young people<br />

—have the right to all information on<br />

the importance of responsible <strong>sex</strong>ual<br />

behaviour and how to effectively<br />

prevent <strong>sex</strong>ually transmitted infections<br />

(STIs) and HIV.<br />

But <strong>talk</strong>ing <strong>about</strong> <strong>sex</strong> with a partner<br />

can have serious consequences<br />

for many women—whether it is a<br />

discussion on how many children<br />

to have, introducing condoms to<br />

the relationship or declining <strong>sex</strong>.<br />

Simply trying to access <strong>sex</strong>ual rights<br />

in a context of harmful traditions or<br />

legislation that do not protect women<br />

often increases their vulnerability<br />

to violence and HIV infection. There<br />

are many forms of violence against<br />

women (VAW) and there is no fixed,<br />

exhaustive list. VAW includes violence<br />

in the family and community such as<br />

battering, marital rape and emotional<br />

abuse like isolation and humiliation.<br />

The ICPD defined reproductive health as:<br />

“…a state of complete physical, mental and social well-being<br />

in all matters relating to the reproductive system and to its<br />

functions and processes. It implies that people have the<br />

capability to reproduce and the freedom to decide if, when<br />

and how often to do so. Implicit in this is the right of men and<br />

women to be informed and to have access to safe, effective,<br />

affordable and acceptable methods of family planning of their<br />

choice, as well as other methods of their choice for regulation<br />

of fertility, which are not against the law, and the right of<br />

access to health-care services that will enable women to go<br />

safely through pregnancy and childbirth.” 1<br />

1 United Nations Department of Public Information * DPI/1618/POP--March 1995<br />

It also includes harmful traditional<br />

practices like female genital mutilation,<br />

child and forced marriage, forced<br />

<strong>sex</strong>ual initiation, acid throwing, <strong>sex</strong>ual<br />

harassment and intimidation at work<br />

or schools, trafficking and forced<br />

sterilisation. 1<br />

In 2007, the <strong>World</strong> <strong>YWCA</strong> further<br />

committed to advancing women’s<br />

rights by including actions on SRHR<br />

in the Nairobi 2007 Call to Action<br />

on HIV and AIDS launched at the<br />

International Women’s Summit on<br />

Women’s Leadership on HIV and AIDS 2 .<br />

In regions where the HIV prevalence<br />

1 1993 UN General Assembly Declaration on the<br />

Elimination of Violence against Women<br />

2 Hosted by the <strong>YWCA</strong> the International Women’s<br />

Summit on Women’s Leadership on HIV and AIDS<br />

was the first international conference to focus on<br />

women’s leadership and HIV and AIDS<br />

www.worldywca.org


CC 8<br />

feature<br />

The <strong>World</strong> <strong>YWCA</strong> has continuously called for<br />

increased access and distribution of the female condom<br />

ICPD Programme<br />

of Action<br />

(A/CONF.171/13):<br />

» Provide universal<br />

education: Urge countries<br />

to provide wider access<br />

to women for secondary<br />

and higher level education<br />

as well as vocational and<br />

technical training.<br />

» Reduce infant and child<br />

mortality<br />

» Reduce maternal mortality<br />

» Ensure universal access<br />

to reproductive health<br />

care, including family<br />

planning, assisted<br />

childbirth and prevention<br />

of <strong>sex</strong>ually transmitted<br />

infections including<br />

HIV. Reduce unintended<br />

pregnancies. Address<br />

impact of unsafe<br />

abortions. Actively<br />

discourage female genital<br />

mutilation (FGM)<br />

www.worldywca.org<br />

is high, access to <strong>sex</strong>ual and<br />

reproductive heath tools like condoms<br />

have a dual effect: they enable women<br />

to plan their families and also offer<br />

protection from HIV and STIs. The<br />

female condom offers women an<br />

additional choice for contraception and<br />

protection. In the 2006 AIDS epidemic<br />

update, UNAIDS reported that in<br />

Thailand a third of new infections were<br />

among married women. In Cambodia,<br />

40% of married women surveyed<br />

reported fear that their husbands<br />

would infect them with HIV 3 . In a recent<br />

survey in East Africa, 40% of married<br />

individuals with HIV have uninfected<br />

partners 4 . For serodiscordant couples<br />

(where only one partner is HIVpositive),<br />

condoms use is crucial to<br />

ensure healthy and pleasurable <strong>sex</strong>ual<br />

relationships.<br />

Comprehensive Condom<br />

Programming for Women<br />

and Girls<br />

On numerous occasions, the <strong>World</strong><br />

<strong>YWCA</strong> has called for increased access<br />

and distribution of the female condom.<br />

But condoms are not the only solution<br />

to preventing HIV. With over 70 member<br />

associations running programmes<br />

on HIV and SRHR, the <strong>World</strong> <strong>YWCA</strong><br />

3 2006 Report on the Global AIDS Epidemic.<br />

UNAIDS<br />

4 2008 Report on the Global AIDS Epidemic.<br />

UNAIDS<br />

understands that a comprehensive<br />

approach is essential to an effective<br />

response to HIV. Early in 2009, the<br />

<strong>World</strong> <strong>YWCA</strong> convened a consultation<br />

to strengthen the global strategy on<br />

SRHR and HIV and AIDS including<br />

condom programming. The revised<br />

strategy offers four goals for the <strong>YWCA</strong><br />

movement to focus its action: create<br />

a safe and inclusive space for women<br />

and girls; provide comprehensive<br />

prevention including comprehensive<br />

condom programming (CCP);develop<br />

leadership and strengthen capacity,<br />

especially with young women as<br />

champions and leaders on SRHR,<br />

HIV and an end to VAW; and ensure<br />

documentation and quality monitoring<br />

and evaluation of <strong>YWCA</strong> programmes.<br />

The strategy will be shared during<br />

the <strong>World</strong> <strong>YWCA</strong> regional training<br />

institutes to be held through 2009 and<br />

early 2010 and will inform regional level<br />

SRHR plans. •<br />

For more information visit:<br />

www.ippf.com<br />

www.guttmacher.org<br />

www.unfpa.org<br />

By Natalie<br />

Fisher-<br />

Spalton,<br />

<strong>World</strong> <strong>YWCA</strong><br />

Deputy<br />

General<br />

Secretary


Feature<br />

CC 9<br />

<strong>World</strong> <strong>YWCA</strong> global strategy<br />

on SRHR, HIV and VAW<br />

A diverse group of people from within the <strong>YWCA</strong> and key partners gathered in Geneva,<br />

Switzerland for a three day global consultation on Sexual and Reproductive Health and Rights<br />

(SRHR) and HIV and AIDS in early 2009. Hosted by the <strong>World</strong> <strong>YWCA</strong>, the consultation was an<br />

opportunity to review and strengthen the <strong>World</strong> <strong>YWCA</strong> HIV and AIDS global strategy to ensure<br />

HIV is addressed through a SRHR framework.<br />

The importance of linking <strong>sex</strong>ual and reproductive<br />

health and rights (SRHR) and HIV has become<br />

widely recognised. 1 International conventions<br />

such as CEDAW and<br />

global commitments such as the<br />

Millennium Development Goals,<br />

Beijing Platform for Action and<br />

the International Conference on<br />

Population and Development<br />

(ICPD) Programme of Action<br />

cannot be met without ensuring<br />

universal access to SRHR and HIV<br />

prevention, treatment, care and<br />

support.<br />

The <strong>World</strong> <strong>YWCA</strong> 2009-2012<br />

strategic framework provides<br />

direction on the links between<br />

accessing information, resources<br />

and services—especially<br />

<strong>sex</strong>ual and reproductive health<br />

services—with prevention, care<br />

and treatment of HIV and AIDS.<br />

To strengthen the strategic<br />

framework, a consultation on the<br />

<strong>World</strong> <strong>YWCA</strong> global strategy on<br />

SRHR and HIV and AIDS including<br />

condom programming was held<br />

in Geneva from February 23-25,<br />

2009.<br />

Supported by the United<br />

Nations Population Fund (UNFPA),<br />

40 participants convened to share<br />

their experience and expertise<br />

on SRHR, HIV and AIDS and<br />

violence against women (VAW).<br />

The outcomes of the consultation<br />

confirmed the importance of<br />

taking a comprehensive and<br />

The <strong>World</strong> <strong>YWCA</strong><br />

strategy affirms that it<br />

is essential to:<br />

1. Create a safe and inclusive<br />

space for women and girls<br />

2. Provide comprehensive<br />

prevention including:<br />

» Comprehensive condom<br />

programming (CCP)<br />

» Integrated information on<br />

SRHR, HIV and VAW that<br />

leads to empowerment<br />

and behaviour change at<br />

community level<br />

» Address stigma and<br />

discrimination of women and<br />

girls living with HIV<br />

3. Develop leadership and build<br />

capacity, especially with<br />

young women as champions<br />

and leaders of SRHR, HIV<br />

and an end to VAW<br />

4. Ensure documentation<br />

and quality monitoring<br />

and evaluation of <strong>YWCA</strong><br />

programmes<br />

integrated approach to SRHR and HIV with a particular<br />

focus on prevention.<br />

The <strong>YWCA</strong> is renowned as a safe space for women,<br />

including young women, in which they<br />

are empowered to take ownership of<br />

their lives. <strong>YWCA</strong>s are therefore ideally<br />

positioned to provide safe and inclusive,<br />

non-judgmental and confidential spaces<br />

for women and girls to discuss and<br />

disclose challenges they face in SRHR,<br />

HIV and AIDS and VAW. Safe spaces can<br />

refer to actual physical space and/or<br />

a gathering of women and girls where<br />

they feel safe to learn and disclose<br />

their <strong>sex</strong>ual and reproductive health<br />

challenges.<br />

Participants:<br />

» Representatives from 16 <strong>YWCA</strong>s from<br />

eight regions<br />

» Key partners: UNFPA, UNAIDS, the<br />

David and Lucile Packard Foundation,<br />

Youth Coalition For Sexual and<br />

Reproductive Health and Rights,<br />

Ecumenical Advocacy Alliance,<br />

Norwegian Church, Aid Masimanyane<br />

Women’s Support Centre, Population<br />

Services International and the Global<br />

Public Sector Team (now called<br />

Support). •<br />

The consultation report is available on the<br />

<strong>World</strong> <strong>YWCA</strong> website, visit:<br />

www.worldywca.org or by email<br />

worldoffice@worldywca.org<br />

1 IPPF, UCSF, UNAIDS, WHO, UNFPA. Sexual &<br />

Reproductive Health and HIV Linkages: Evidence<br />

Review and Recommendations. 2008.<br />

www.worldywca.org


girl<br />

For every ..............<br />

We want to live in a world where<br />

every girl will grow up to have:<br />

n access to quality education<br />

n appropriate <strong>sex</strong> education teaching her essential<br />

life skills in taking responsibility for her own <strong>sex</strong>uality<br />

n information on how HIV is transmitted and how it<br />

is not transmitted<br />

n access to confidential voluntary counseling and<br />

HIV-testing and know her HIV status<br />

n access to the best and most effective HIV treatment if<br />

she is HIV-positive and freedom to choose whom to tell<br />

<strong>about</strong> her HIV status<br />

n skills to negotiate condom use and access to low cost<br />

female and male condoms<br />

n knowledge on how to prevent unintended pregnancies and<br />

access contraception suited to her needs<br />

n freedom to choose when to marry and whom to marry<br />

n freedom to choose when and if to have children, regardless<br />

of her HIV status<br />

n access to health facilities that would help her survive<br />

childbirth when she is old enough to have children<br />

n access to regular screening and treatment<br />

for cervical and breast cancer<br />

www.worldywca.org<br />

....


CC 11<br />

Take Action<br />

Looking through the cross<br />

at violence against women<br />

A<br />

genuinely Christian<br />

perspective is<br />

against all forms<br />

of violence against<br />

women. Christianity proclaims<br />

a God who is defined by love<br />

and who wants to be personally<br />

involved in helping women and<br />

men become whole people<br />

in societies marked by justice<br />

with peace. Violence against<br />

women works exactly against<br />

this goal. When a husband<br />

believes he can demand <strong>sex</strong><br />

from his wife; or a woman is<br />

gossiped <strong>about</strong> or shamed<br />

in the community when she<br />

reveals that her boyfriend or<br />

husband is abusing her; or a<br />

girl is deprived an education<br />

in favor of a boy; or a woman<br />

is denied in a thousand large<br />

and small ways the possibility<br />

of developing her full potential<br />

and personhood—it is violence<br />

against the dignity of women.<br />

When any of these actions are linked somehow with God,<br />

they can be even more devastating.<br />

In the first pages of the Bible we see God created men<br />

and women both in God’s image with inherent value and<br />

with the capacity to create, reason and love (1). Jesus treated<br />

women with kindness and respect. In a context where<br />

women were not valued as highly as men and did not have<br />

the same rights as men, Jesus<br />

defended women, healed women,<br />

and developed friendships with<br />

women, even women outcast in<br />

their society (2). At a time when<br />

a woman’s testimony was not<br />

considered valid, Jesus chose to<br />

appear first to women after his<br />

resurrection (3).<br />

Thinking theologically <strong>about</strong><br />

the real issues of life allows<br />

us to ask and articulate how<br />

faith can make a difference. It<br />

allows us to ask questions <strong>about</strong><br />

interpretations of the Bible that<br />

seem to limit women. It allows<br />

us to find new ways of relating<br />

the biblical texts to our current<br />

experiences and needs.<br />

One strong example of a<br />

new reading and application<br />

of a familiar text is the Tamar<br />

Campaign, whose aim is<br />

to mobilise and sensitise<br />

girls, women, men, media,<br />

faith organisations, religious<br />

institutions and others to say no to rape and domestic<br />

violence. It is centered around a Bible study of the story of<br />

Tamar in 2 Samuel 13:1-22. Tamar, David’s daugther, was<br />

raped by Ammon, her half brother. A symbol of violence<br />

against women, Tamar was not only abused but also<br />

courageously spoke out against her abuse. Her powerful act<br />

can encourage other women to speak out against abuse.<br />

Rape and <strong>sex</strong>ual assault are widely recognised as crimes, although in 44 countries<br />

legislation is yet to be developed (UNIFEM 2003 Report)<br />

www.worldywca.org


CC 12<br />

Take Action<br />

Evidence shows violence against<br />

women damages not only the individual<br />

women but the whole society. HIV<br />

and AIDS spreads when women do<br />

not have the education or freedom to<br />

make informed choices <strong>about</strong> <strong>sex</strong>uality<br />

or are coerced <strong>sex</strong>ually. And when<br />

men are perpetrating or allowing<br />

violence against women, knowingly<br />

or unknowingly, neither men nor<br />

women are living as they are created<br />

to be—in wholeness and mutuality.<br />

The church and Christians are called<br />

to speak out against all forms of<br />

violence against women, even and<br />

especially when we find it in our own<br />

communities, proclaiming through our<br />

actions that violence is unequivocably<br />

unacceptable and that the God of<br />

lovingkindness is in our midst ready to<br />

heal and restore. •<br />

References:<br />

1 Genesis 1<br />

2 Matthew 9:19-21; Luke 10/John 11;<br />

John 8<br />

3 Luke 24/Mark 16<br />

By Christine Housel, <strong>World</strong><br />

Student Christian Federation<br />

Christine Housel<br />

received her<br />

Masters of Divinity<br />

from Yale Divinity<br />

School (01) and is<br />

a member of the<br />

Episcopal Church.<br />

She currently lives<br />

in Geneva,<br />

Switzerland where<br />

she works as<br />

Global Project Manager for the <strong>World</strong><br />

Student Christian Federation. One area<br />

of passion for Christine is working<br />

together with girls and women to find<br />

their full potential as women and to<br />

discover how to stand against all forms<br />

of violence, in partnership with likeminded<br />

men. The <strong>World</strong> Student Christian<br />

Federation has been a long-time<br />

partner with the <strong>World</strong> <strong>YWCA</strong> in<br />

empowering women and working for<br />

gender justice.<br />

For more information on the Tamara<br />

Campaign contact the Ujamaa Centre:<br />

labanc@ukzn.ac.za<br />

For more information on the <strong>World</strong><br />

Student Christian Federation visit:<br />

www.wscfglobal.org<br />

Pregnancy<br />

Matters<br />

Maternal mortality<br />

and the human<br />

rights of women<br />

By holding government’s accountable to the Programme of<br />

Action and MDG 5 and supporting women with services that<br />

contribute to preventing unnecessary deaths, <strong>YWCA</strong>s can<br />

play a crucial role in achieving women’s reproductive rights.<br />

In the least developed<br />

countries, only<br />

39%<br />

of women have a skilled<br />

attendant during their<br />

childbirth.<br />

1 UNICEF, State of the <strong>World</strong>’s Children<br />

Report 2008<br />

Global statistics show<br />

that over 500,000<br />

women die each year<br />

from complications<br />

during pregnancy or childbirth;<br />

99% of these occur in developing<br />

countries. The conditions that<br />

enable these unnecessary<br />

deaths vary, but timely strategies<br />

to improve the lives of women<br />

and girls can reduce the risk of<br />

pregnancy and childbirth.<br />

The journey to a successful<br />

pregnancy for a woman in the<br />

developing world can be perilous. Assuming she is not a child forced into<br />

marriage facing her first pregnancy at fourteen, her closest maternal care<br />

clinic may be 40 kilometres away. For the fourteen year-old, unattended<br />

complications during childbirth may lead to obstetric fistula— a severe<br />

medical condition in which a hole develops between the rectum/bladder<br />

and vagina.<br />

For the woman with access to antenatal care, a mandatory HIV test may<br />

reveal that she is HIV-positive. Often with no support or counselling, she has<br />

to face her partner and family with the news. Assuming her partner does not<br />

beat or abuse her for ‘bringing HIV into the home’, she may have no access<br />

to antiretroviral medication that would ensure her baby is born HIV-negative<br />

and she has a healthy life during which she can raise and care for her child.<br />

www.worldywca.org


Take Action<br />

CC 13<br />

And what if she was circumcised<br />

as a girl? The <strong>World</strong> Health<br />

Organisation (WHO) reports that<br />

female genital mutilation increases<br />

risk of childbirth complications and<br />

newborn deaths.<br />

Upholding women’s<br />

rights<br />

The strategies to ensure women<br />

can have safe pregnancies are<br />

multi-fold: from ensuring girls stay<br />

in school and are not forced into<br />

marriage to providing adequate<br />

health care. But to be successful,<br />

these strategies must be centred<br />

on reducing poverty, eliminating<br />

inequality and eradicating harmful<br />

gender norms and traditions. By<br />

upholding a girl’s right to health<br />

from when she is born to when she is<br />

elderly, governments can ensure not<br />

only women’s wellbeing but society’s<br />

as well.<br />

The impact women’s poor health<br />

has on the community, economy<br />

and country is increasingly being<br />

recognised by governments and<br />

world leaders. At the March 2009<br />

session of the Human Rights Council,<br />

83 governments reaffirmed their<br />

commitment to addressing maternal<br />

mortality as a human rights issue.<br />

Governments identified specific<br />

steps the Council can take and<br />

requested that member states<br />

include women in decision-making<br />

around maternal health 1 .<br />

The International Conference on<br />

Population and Development (ICPD)<br />

held in Cairo in 1994 concluded with<br />

pledges outlined in a Programme<br />

of Action. The outcomes of the<br />

ICPD in turn informed the language<br />

of Millennium Development Goal<br />

5 on maternal health. The ICPD<br />

Programme of Action and MDG<br />

5 provide a clear framework for<br />

action to achieve universal access to<br />

reproductive health services by<br />

2015. Women’s organisations like<br />

the <strong>YWCA</strong>—with its experience in<br />

1 WomenDeliver.org news retrieved 29.04.09<br />

providing services and history of<br />

advocating for women’s rights—are<br />

well placed to respond to the needs<br />

of women and girls. By holding<br />

government’s accountable to the<br />

Programme of Action and MDG<br />

5 and supporting women with<br />

services that contribute to preventing<br />

unnecessary deaths, <strong>YWCA</strong>s can<br />

play a crucial role in achieving<br />

women’s reproductive rights. •<br />

MDG 5: Improve<br />

Maternal Health<br />

Target 5.A:<br />

Reduce by three quarters,<br />

between 1990 and 2015, the<br />

maternal mortality ratio<br />

Indicators:<br />

5.1 Maternal mortality ratio<br />

5.2 Proportion of births<br />

attended by skilled health<br />

personnel<br />

Target 5.B:<br />

Achieve, by 2015, universal<br />

access to reproductive health<br />

Indicators:<br />

5.3 Contraceptive prevalence<br />

rate<br />

5.4 Adolescent birth rate<br />

5.5 Antenatal care coverage<br />

(at least one visit and at least<br />

four visits)<br />

5.6 Unmet need for family<br />

planning<br />

www.worldywca.org


CC 14<br />

Young Women<br />

on the Move<br />

What does Sexual and<br />

Reproductive Health<br />

and Rights mean to you?<br />

Contraception, <strong>sex</strong>uality, pregnancy, violence, menstruation,<br />

<strong>sex</strong>ually transmitted infections…it can be information overload<br />

for young women when discussing <strong>sex</strong>ual and reproductive<br />

health and rights. In this section of Common Concern, we ask<br />

young women from around the world to share what <strong>sex</strong>ual<br />

and reproductive health and rights (SRHR) means to them.<br />

Maria Morena<br />

Galvelo, 30<br />

Philippines<br />

<strong>World</strong> <strong>YWCA</strong> Board Member<br />

and <strong>YWCA</strong> of Philippines<br />

member<br />

Sexual reproductive health<br />

and rights are integral to our<br />

existence as humans. God<br />

created us with <strong>sex</strong>uality<br />

that should be treated with respect and<br />

free from all forms of discrimination<br />

and violence that rob human dignity.<br />

It disturbs me to hear that my fellow<br />

Filipino women work abroad and<br />

suffer physical and <strong>sex</strong>ual abuse<br />

from their foreign employers.<br />

Discrimination, cruelty and<br />

violence against young women’s<br />

SRHR will continue if no action<br />

is taken. Everyone plays a role<br />

in changing this– individuals,<br />

families, communities and the<br />

government that leads the nation.<br />

Andrea Núñez<br />

Argote, 24 Mexico<br />

<strong>World</strong> <strong>YWCA</strong> Advocacy<br />

Intern and <strong>YWCA</strong> of<br />

Naucalpan member<br />

I<br />

first heard <strong>about</strong> <strong>sex</strong>ual<br />

reproductive health and<br />

rights during my phone<br />

interview for the <strong>World</strong> <strong>YWCA</strong><br />

Internship. I wasn’t sure what it meant<br />

or the difference so I used the Internet<br />

to find out.<br />

www.worldywca.org


Young women on the move<br />

CC 15<br />

When young people are unaware<br />

of SRHR or what the difference<br />

is between them, they can make<br />

uninformed choices and be left<br />

vulnerable to violations of these rights<br />

that they start to accept as normal.<br />

I did not get taught <strong>sex</strong>ual or<br />

reproductive health at school. These<br />

topics were in our health books but<br />

teachers just skipped the subject. Only<br />

now I realise how important it is for<br />

young people that these issues are<br />

addressed. Today, teachers still refuse<br />

to teach <strong>about</strong> <strong>sex</strong>ual health.<br />

In the <strong>YWCA</strong> of Naucalpan we<br />

provide workshops for students to<br />

understand and exercise their SRHR in<br />

the best possible way. We are filling the<br />

gap teachers do not want to fill.<br />

Sita Shahi, 30 Nepal<br />

Srijansil Mahila Samuha,<br />

People Living with HIV (PLHIV)<br />

women’s group<br />

Sexual reproductive health<br />

and rights are important<br />

to young people. Due to<br />

the lack of education on<br />

<strong>sex</strong>ual and reproductive health, many<br />

women are becoming infected with<br />

HIV. If young women are not informed<br />

of their <strong>sex</strong>ual and reproductive health<br />

rights, they can engage in risky <strong>sex</strong>ual<br />

behaviour which can lead to HIV and<br />

<strong>sex</strong>ually transmitted infections. Family,<br />

school and society need to <strong>talk</strong> openly<br />

<strong>about</strong> these issues<br />

Women who are uninformed of<br />

SRHR can become victims of physical<br />

and mental violence, early and<br />

unplanned pregnancy and HIV.<br />

Young women have a right to live a<br />

free life and their SRHR should not be<br />

exploited.<br />

Sepora Tagaloa, 22<br />

American Samoa<br />

<strong>World</strong> <strong>YWCA</strong> Board member<br />

and <strong>YWCA</strong> of American Samoa<br />

member<br />

I<br />

am a young woman that<br />

belongs to a conservative<br />

culture that labels all things<br />

<strong>sex</strong>ual as taboo. I learned<br />

<strong>about</strong> my <strong>sex</strong>ual health when I<br />

was prescribed birth control to<br />

regulate an irregular cycle. The<br />

nurse scoffed at me, presuming<br />

I was an out-of-control <strong>sex</strong>ually<br />

active teenager. I was 14 years<br />

old and unaware of what my body<br />

was experiencing. My parents, and<br />

schools I attended did not discuss<br />

my reproductive health.<br />

I believe <strong>sex</strong>ual education<br />

should be included in the education<br />

framework of primary schooling.<br />

Providing young women with <strong>sex</strong>ual<br />

education enables them to make<br />

well-informed decisions <strong>about</strong><br />

their <strong>sex</strong>ual health. Also, providing<br />

the entire community with <strong>sex</strong>ual<br />

education will generate an open and<br />

understanding perspective for the<br />

betterment of young women’s social<br />

and <strong>sex</strong>ual wellbeing.<br />

Aika Temu, 30<br />

Tanzania<br />

<strong>World</strong> <strong>YWCA</strong> Accountant<br />

Wait until you’re married.<br />

Abstain. You will get<br />

an STD. Pregnant. No<br />

man will want you. He<br />

is your husband. You must please him.<br />

Condoms are against Gods plans<br />

for procreation…a snapshot of the<br />

information young women received<br />

where I grew up.<br />

No one <strong>talk</strong>ed <strong>about</strong> how<br />

to handle advances from men<br />

in positions of power, how<br />

to negotiate safe <strong>sex</strong> or the<br />

facilities available if you had<br />

difficult decisions to make.<br />

So we watched in silence<br />

hiding behind guilt, shame,<br />

religion, culture and society as<br />

women suffered and some died.<br />

We have done this for too long.<br />

www.worldywca.org


CC 16<br />

Leading Change<br />

Higher education,<br />

higher risks<br />

<strong>YWCA</strong> of Ethiopia responds to university<br />

women’s <strong>sex</strong>ual and reproductive health needs<br />

University should be a liberating and empowering experience for young women. When the<br />

<strong>YWCA</strong> of Ethiopia discovered female students faced a range of barriers that impacted on<br />

their <strong>sex</strong>ual and reproductive health and rights, they decided to provide support to young<br />

women and challenge the status quo.<br />

Female students in higher<br />

learning institutes in Ethiopia<br />

face many problems<br />

that pose a challenge to<br />

the successful completion of their<br />

studies. The <strong>YWCA</strong> of Ethiopia has<br />

found typical challenges identified<br />

by female university students include<br />

economic problems, especially<br />

for rural female students, <strong>sex</strong>ual<br />

and verbal harassment and lack of<br />

sufficient knowledge on reproductive<br />

health including HIV. Unintended<br />

pregnancies and abortion are some<br />

of the consequences. The social<br />

support within the university system<br />

is also weak; there is little guidance<br />

and counseling for students who<br />

find it difficult to cope with the new<br />

academic and social environment.<br />

The unsafe environment on university<br />

campuses, like dormitories situated at<br />

inconvenient locations, make female<br />

student vulnerable to violence. All of<br />

these challenges ultimately contribute<br />

to low academic performance thereby<br />

increasing female university dropouts.<br />

It is in this context that a university<br />

official approached the <strong>YWCA</strong> of<br />

Ethiopia to intervene. Bearing in<br />

mind the gap between the favorable<br />

government’s policy framework on<br />

education, health and gender and the<br />

reality on university campuses, the<br />

<strong>YWCA</strong> of Ethiopia felt that there was an<br />

urgent need for intervention. Removing<br />

the hurdles faced by female students<br />

in higher learning institutes has now<br />

become the <strong>YWCA</strong>’s major concern.<br />

With the assistance of the David<br />

and Lucile Packard Foundation,<br />

the <strong>YWCA</strong> of Ethiopia started the<br />

‘Enhancement of Women and Girls<br />

Reproductive Rights in Ethiopia’ project<br />

that currently runs in two Addis Ababa<br />

university campuses.<br />

Supporting<br />

underprivileged women<br />

The <strong>YWCA</strong> of Ethiopia understands<br />

that building the capabilities of young<br />

women through education and creating<br />

healthy citizens whose reproductive<br />

health needs and rights are<br />

safeguarded is a path to development.<br />

To help women stay in school and<br />

address the economic challenges that<br />

sometimes lead female students to<br />

engage in paid <strong>sex</strong> with older men, an<br />

empowerment scheme was developed<br />

that offers 100 underprivileged<br />

students a monthly stipend of Birr<br />

100 (approximately USD 9). With Birr<br />

100, a student is able to buy sanitary<br />

pads, shampoo, body lotion and make<br />

photocopies. As books in the library<br />

are not sufficient, young women prefer<br />

to make photocopies and read in their<br />

dormitory, which is safer than going to<br />

the library late at night.<br />

In addition to financial support,<br />

the women in the programme also<br />

participate in a mentoring and<br />

training programme. The programme<br />

delivers training on reproductive<br />

health, leadership and human rights.<br />

The <strong>YWCA</strong> of Ethiopia already has<br />

existing initiatives on violence against<br />

women and reproductive health in<br />

high schools and used the experience<br />

and knowledge from running these<br />

programmes to implement the<br />

university training.<br />

www.worldywca.org


Leading Change<br />

CC 17<br />

The <strong>YWCA</strong> of Ethiopia staff and supporters at the launch<br />

of the condom kiosk at Addis Ababa University.<br />

The condom kiosk<br />

The <strong>YWCA</strong> of Ethiopia realised that<br />

female students had little access to<br />

contraceptives and this had a negative<br />

impact on their <strong>sex</strong>ual health. Through<br />

the contacts established within the<br />

university and government Ministries,<br />

the <strong>YWCA</strong> received permission to set<br />

up condom kiosks at the Addis Ababa<br />

University. In partnership with DKT<br />

Ethiopia, a leading contraceptives<br />

supplier, the kiosk was set up next to<br />

the female dormitory to provide young<br />

women with <strong>sex</strong>ual and reproductive<br />

health services. The <strong>YWCA</strong> hopes the<br />

location of the kiosk will encourage<br />

female students to use the service<br />

without shame. It will facilitate access<br />

to contraceptives such as condoms,<br />

the contraceptive pill and sanitary<br />

pads for female students. The project<br />

is sustainable; proceeds from the sale<br />

of the subsidised products will go to<br />

the establishment of a women’s fund.<br />

One of the major challenges of<br />

implementing the project was soliciting<br />

support from stakeholders working<br />

on campus, both governmental and<br />

non-governmental organisations. The<br />

challenge was overcome by engaging<br />

in advocacy work with the NGOs<br />

and government representatives to<br />

convince them of the importance of<br />

encouraging <strong>sex</strong>ual and reproductive<br />

health among university students.<br />

Despite the barriers, the <strong>YWCA</strong> of<br />

Ethiopia remains passionate <strong>about</strong><br />

addressing <strong>sex</strong>ual and reproductive<br />

health rights of young women in<br />

Ethiopia. •<br />

By Melat Tekletsadik Haile,<br />

General Secretary of the <strong>YWCA</strong><br />

of Ethiopia<br />

For more <strong>about</strong> the David and Lucile<br />

Packard Foundation visit:<br />

www.packard.org<br />

For more <strong>about</strong> the <strong>YWCA</strong> of Ethiopia<br />

visit: www.ywca-ethiopia.org<br />

Nearly 60% of the<br />

104 million<br />

children globally who<br />

do not attend school<br />

are girls, with HIV<br />

rates higher for girls<br />

who do not finish<br />

primary school.<br />

-------------------------------------------------<br />

1 in 7<br />

girls in developing<br />

countries marry<br />

before age 15. In 17<br />

countries in South<br />

Asia and Sub-Saharan<br />

Africa, almost half of<br />

all girls are married<br />

before age 18<br />

www.worldywca.org


CC 18<br />

leading Change<br />

Sexual Exploitation and<br />

Violence Against Women<br />

Breaking the Poto Mitan of Haitian Society<br />

In general, forced <strong>sex</strong>ual relations within marriage or partnership are not perceived<br />

by the majority of Haitian men and women as violence, although 8 out of 10 women<br />

in Haiti are victims of domestic violence.<br />

Se fanm qui ranje tab la, e<br />

se li ki ranje lavi a” (It is a<br />

woman who prepares the<br />

table and it is her who puts<br />

life in order. Women are central to<br />

everything in life.)<br />

Marie-Claude Julsaint, <strong>World</strong><br />

<strong>YWCA</strong> Regional Director for the<br />

Americas and the Caribbean<br />

participated in a solidarity visit to Haiti<br />

in November 2008. Born and raised in<br />

Haiti until she left at age 17 to attend<br />

University in the United States, Julsaint<br />

returned to Haiti after 10 years. In this<br />

piece, she reflects on the situation of<br />

women and girls in Haiti.<br />

In Haitian culture, women are<br />

referred to as the poto mitan of the<br />

society. The poto mitan is the central<br />

post in a voodoo temple that serves as<br />

the connection between the spiritual<br />

and the physical world; it is the conduit<br />

for the spirits to enter the physical<br />

world during a voodoo ceremony.<br />

Women are therefore the central beam<br />

that keeps everything in order and<br />

connected.<br />

Since the slave revolt, which<br />

brought independence in 1804, women<br />

have played an important role and<br />

stand out as key figures in Haiti’s<br />

history. Today, women contribute up to<br />

70% of the national economy through<br />

their participation in the informal<br />

sector . However, Haitian women face<br />

many forms of violence in a context of<br />

extreme poverty, discrimination and<br />

gender inequality.<br />

Poverty and marginalisation have<br />

contributed to the current situation<br />

of increasing <strong>sex</strong>ual exploitation and<br />

<strong>sex</strong>ual violence against young women<br />

and girls; this impacts their <strong>sex</strong>ual and<br />

reproductive health and rights. Data<br />

and information on <strong>sex</strong>ual exploitation<br />

and <strong>sex</strong>ual violence against women<br />

and girls need to improve in order<br />

for an effective response to be<br />

implemented.<br />

In general, forced <strong>sex</strong>ual relations<br />

within marriage or partnership are not<br />

perceived by the majority of Haitian<br />

men and women as violence, although<br />

8 out of 10 women in Haiti are victims<br />

of domestic violence.<br />

There are also many reported<br />

cases of <strong>sex</strong>ual violence, including<br />

rape of girl-child domestic servants,<br />

commonly known as the restaveks.<br />

Trafficking of women and girls and<br />

forced repatriation of women at the<br />

Haitian-Dominican Republic border<br />

often includes <strong>sex</strong>ual violence and<br />

rape. This also puts women and girls<br />

at greater risk of HIV infection.<br />

Despite these alarming statistics<br />

and reports, I heard many powerful<br />

and inspiring stories of the courage<br />

and resilience of Haitian women who<br />

are able and dynamic leaders of their<br />

communities. Many governmental,<br />

civil society and women’s initiatives<br />

exist, including the establishment<br />

in 1994 of the Ministry for the Status<br />

of Women and Women’s Issues, the<br />

National Dialogue on Violence Against<br />

Women, Haiti’s National Plan to<br />

Combat Violence Against Women, and<br />

more recently the developing <strong>YWCA</strong><br />

of Haiti which started its activities in<br />

2006, focusing on women’s health and<br />

HIV, girls education and leadership<br />

development. All these initiatives<br />

demonstrate that the perception<br />

of women as poto mitan is not only<br />

a social factor but is becoming an<br />

institutionalised element of Haitian<br />

society. •<br />

By Marie-Claude Julsaint, <strong>World</strong><br />

<strong>YWCA</strong> Regional Director for the<br />

Americas and the Caribbean<br />

www.worldywca.org


CC 19<br />

HIV and AIDS<br />

Forced and coerced<br />

sterilisation of HIV-Positive<br />

Women: A Human Rights Issue<br />

Guaranteeing women’s human right to free and<br />

informed reproductive healthcare decision-making<br />

What are the duties of [care] providers and<br />

ministries of health to ensure that women<br />

living with HIV are fully informed and have<br />

the capacity to freely decide whether or not<br />

to become pregnant, to carry a pregnancy to term or to<br />

terminate a pregnancy?<br />

In 2006, the UNAIDS Agenda for Action on Women<br />

and AIDS responded to the gendered impact of HIV and<br />

AIDS by calling on governments to ensure that AIDS<br />

health programmes ‘work for women’ – in particular<br />

by “…expanding access to health services that women<br />

need including comprehensive education, <strong>sex</strong>ual and<br />

reproductive health services, antenatal care, prevention<br />

of mother-to-child transmission (PMTCT) programs and<br />

equitable access to antiretroviral therapy (ARV). 1 ”<br />

The agenda has been largely developed in response<br />

to early HIV and AIDS health programming, which too<br />

often regarded women in instrumentalist terms. 2 The<br />

programming was characterised by a focus on preventing<br />

transmission from mothers to their infants, without looking<br />

to the prevention of transmission from parents to children.<br />

Other dominant encounters with ‘mothers’ include the<br />

15 million children orphaned or abandoned due to HIVrelated<br />

ill-health or death of their parents. The common<br />

understanding had been that it was mothers who infected<br />

and who orphaned or abandoned their children.<br />

Reproductive healthcare in the HIV and AIDS context<br />

has thus been complicated by public health concerns<br />

respecting ‘mother-to-child transmission’, and the future<br />

care of children born to women living with HIV. 3 As a result,<br />

HIV positive women have encountered, and continue to<br />

experience, both subtle and overt pressure from health<br />

providers, partners, families, communities and the state to<br />

terminate existing, and to avoid future, pregnancies. In 1998,<br />

the South African Medical Journal published a letter from a<br />

hospital staff-member which stated “…(i) The availability of<br />

antiretroviral treatment should be conditional on voluntary<br />

or enforced sterilisation after the present pregnancy; (ii)<br />

…termination of pregnancy should be considered in HIVinfected<br />

pregnant women, either voluntarily or by law; (iii)<br />

an Act of Parliament should be considered to the effect that<br />

all HIV-infected women in their reproductive years should be<br />

sterilised. 4 ”<br />

www.worldywca.org


CC 20<br />

HIV and AIDS<br />

HIV positive women from around the world face many SRHR violations that include<br />

forced and coerced sterilisation, refusal to provide services, hostile attitudes towards<br />

HIV positive women who seek to have children, stigmatisation at hospitals by hospital<br />

staff, breaches of confidentiality, and testing for HIV without informed consent.<br />

Although many health professionals may not openly<br />

voice such opinions, research studies and anecdotal reports<br />

indicate that such attitudes are widespread. 5 The High<br />

Commissioner for Human Rights (OHCHR) and UNAIDS<br />

have expressly addressed this problem of coercion. In a<br />

1998 statement, OHCHR noted that programmes targeting<br />

pregnant women “often emphasise coercive measures<br />

directed towards the risk of transmitting HIV to the foetus,<br />

such as mandatory testing followed by coerced abortion or<br />

sterilisation. 6 ”<br />

While attitudes have slightly shifted since the introduction<br />

and greater availability of anti-retroviral therapy, too few HIV<br />

positive pregnant women are able to access the treatment<br />

and services they require. In many cases, providers do not<br />

perceive their advice as coercive but instead as providing<br />

‘counseling and guidance’ to women who face many<br />

challenges in the bearing and raising of children as a<br />

consequence of their HIV positive status.<br />

A human rights approach to free and informed<br />

reproductive health decision-making is guided by the<br />

principle that all women have a right to reproductive<br />

autonomy including the right to bear children, regardless<br />

of their HIV status. The Convention on the Elimination of<br />

Discrimination against Women 7 [CEDAW], for example,<br />

provides that women’s human rights are violated by the<br />

failure to both ensure non-discriminatory access to health<br />

services and to protect women from non-consensual<br />

medical interventions. Rather, women are entitled by right<br />

to acceptable healthcare services defined as ”… those that<br />

are delivered in a way that ensures that a woman gives her<br />

fully informed consent, respects her dignity, guarantees<br />

her confidentiality and is sensitive to her needs and<br />

perspectives. 8 ”<br />

Coercive (or non-consensual) medical interventions,<br />

including abortion and sterilisation, constitute grave<br />

violations of women’s human rights as guaranteed not<br />

only in CEDAW, but also the International Covenant on<br />

Civil and Political Rights (the Political Covenant) 9 , and the<br />

International Covenant on Economic, Social and Cultural<br />

Rights (the Economic Covenant). 10 The violation of women’s<br />

human rights to acceptable reproductive health care also<br />

undermines broader public health goals by dissuading<br />

women from seeking care and services. 11 Women may<br />

be deterred ”…from accessing care, because of the<br />

negative associations of HIV, or because they anticipate<br />

or experience prejudicial behaviour from healthcare<br />

providers. 12 ”<br />

The guarantee of women’s human right to free and<br />

informed reproductive healthcare decision-making is,<br />

thus, essential from both a human rights and a public<br />

health perspective. While a woman’s HIV positive status<br />

may influence her healthcare decision-making, it should<br />

not result in her discriminatory treatment at the hands<br />

of health providers or the health system. Prevention and<br />

other health programmes should provide information and<br />

access to services in a manner that respects the dignity of<br />

women by facilitating their free and informed reproductive<br />

decision-making. In the 1998 Guidelines on HIV/AIDS and<br />

Human Rights, UNAIDS and OHCHR expressly recognised<br />

that ”…[l]aws should…be enacted to ensure women’s<br />

reproductive and <strong>sex</strong>ual rights, including the right of<br />

independent access to reproductive and STD health<br />

information and services and means of contraception,<br />

including safe and legal abortion and the freedom to choose<br />

among these, the right to determine number and spacing of<br />

children. 13 ”<br />

The tension between public health and human rights<br />

approaches in reproductive health decision-making, to the<br />

extent that there is one, usually arises not from a difference<br />

in objectives, but a difference in chosen means to achieve<br />

legitimate public health objectives. Rather than viewing<br />

public health and human rights approaches in starkly<br />

opposing terms, it is more useful and more accurate to<br />

consider how existing tensions in implementation can be<br />

overcome. •<br />

Extract from: ‘Bridging the Gap: Developing a<br />

Human Rights Framework to Address Coerced<br />

Sterilization and Abortion’. ATHENA. 2008<br />

References:<br />

1. UNAIDS, The Global Coalition on Women and AIDS. 2006. Keeping the<br />

Promise: An Agenda for Action on Women and AIDS.<br />

2. See Cohen, J., Kass, N. & Beyrer, C. 2007. ‘Responding to the Global HIV/<br />

AIDS Pandemic: Perspectives from Human Rights and Public Health Ethics’.<br />

3. de Bruyn, M. 2002. Reproductive choice and women living with HIV/AIDS.<br />

Chapel Hill, NC:<br />

4. Ibid, p13.<br />

5. Supra note 3.<br />

6. OHCHR and UNAIDS. 1998. HIV/AIDS and Human Rights<br />

7. Convention on the Elimination of All Forms of Discrimination against<br />

Women. A/Res/34/180<br />

8. Committee on the Elimination of All Forms of Discrimination against Women<br />

(CEDAW). 1999. General Recommendation 24: Women and health. para 22.<br />

9. International Covenant on Civil and Political Rights. A/6316.<br />

10. International Covenant on Economic, Social and Cultural Rights. A/6316.<br />

11. The notion that human rights protection promotes public health is commonly<br />

referred to as the HIV/AIDS paradox. See MacFarlane, S., Racelis,<br />

M. & Muli-Muslime, F. 2000. Specifically, the HIV/AIDS paradox teaches that<br />

behaviour modification is best achieved by protecting the rights of vulnerable<br />

groups.<br />

12. de Bruyn, T. 2002. ‘HIV-Related Stigma and Discrimination: The Epidemic<br />

Continues’. In: Canadian HIV/AIDS Policy & Law Review, 7(1), 8 at 9.<br />

13. OHCHR UNAIDS. 1997. HIV/AIDS and Human Rights: International Guidelines.<br />

Second International Consultation on HIV/AIDS and Human Rights.<br />

HR/PUB/98/1, 20-21.<br />

www.worldywca.org


CC 21<br />

Briefing<br />

From the <strong>World</strong> <strong>YWCA</strong><br />

Vienna to host<br />

world’s largest<br />

international<br />

conference on HIV<br />

and AIDS<br />

<strong>World</strong> <strong>YWCA</strong> Programme Director for Asia and Pacific Juli Dugdale celebrated<br />

<strong>World</strong> <strong>YWCA</strong> Day with the <strong>YWCA</strong> of Thailand<br />

<strong>World</strong> <strong>YWCA</strong> Day<br />

Celebrates Women<br />

Creating a Safe<br />

<strong>World</strong><br />

Over 40 friends and<br />

partners of the <strong>World</strong><br />

<strong>YWCA</strong> joined in <strong>World</strong><br />

<strong>YWCA</strong> Day celebrations in<br />

Geneva, Switzerland on April 24, 2009.<br />

The occasion was an opportunity to<br />

reflect on the <strong>World</strong> <strong>YWCA</strong> Day theme<br />

‘Women Creating a Safe <strong>World</strong>’ and<br />

the event involved a number of different<br />

presentations including ‘Honouring<br />

Women Leaders’ and an introduction to<br />

<strong>World</strong> <strong>YWCA</strong> Council 2011.<br />

“Today, we are saying it is possible<br />

to have a different world. Together we<br />

can create a different world; a world<br />

free of violence, free of HIV—where<br />

humanity is celebrated and human<br />

dignity is a lived experience every<br />

day, every where,” said <strong>World</strong> <strong>YWCA</strong><br />

General Secretary Nyaradzayi<br />

Gumbonzvanda.<br />

<strong>World</strong> <strong>YWCA</strong> President Susan<br />

Brenann sent a message to the <strong>YWCA</strong><br />

movement stating, “<strong>YWCA</strong>s globally<br />

are honouring women leaders and<br />

celebrating women’s leadership<br />

in creating a safe world. We are<br />

celebrating the <strong>YWCA</strong> as a safe space.<br />

Safe because we provide shelter and<br />

places to gather, safe because we<br />

welcome all women, regardless of their<br />

circumstances.”<br />

For more, visit:<br />

www.worldywca.org for stories on<br />

<strong>YWCA</strong>s celebrating <strong>World</strong> <strong>YWCA</strong> Day<br />

www.YouTube.com/worldywca for General<br />

Secretary’s video message<br />

www.Flickr.com/worldywca for photos<br />

from <strong>YWCA</strong>s around the world<br />

Vienna, Austria will host the<br />

XVIII International AIDS<br />

Conference (AIDS 2010),<br />

the largest international<br />

meeting on HIV. The biennial<br />

conference attracts close to 25,000<br />

people, representing all stakeholders<br />

in the global response to HIV, to<br />

address the gaps, assess progress<br />

and identify future priorities in the<br />

response to HIV and AIDS.<br />

The International AIDS Society<br />

(IAS), in partnership with civil society,<br />

government, other international<br />

and scientific partners from Austria<br />

and other parts of the world, will<br />

convene AIDS 2010. The <strong>World</strong> <strong>YWCA</strong><br />

is a member of the Conference<br />

Coordinating Committee (CCC)<br />

representing women, young people<br />

and faith-based organisations. As<br />

part of the planning committee, the<br />

<strong>World</strong> <strong>YWCA</strong> is working to ensure that<br />

these constituencies are meaningfully<br />

mainstreamed to all aspects of the<br />

conference agenda.<br />

The conference has great potential<br />

to engage Central Asia and Europe,<br />

especially Russia, in addressing<br />

HIV and AIDS. Russia accounts for<br />

two-thirds of all HIV cases in Eastern<br />

Europe and many believe Central Asia<br />

has one of the fasts growing epidemic<br />

in the world.<br />

For more, visit: www.aids2010.org<br />

www.worldywca.org


CC 22<br />

Briefing<br />

<strong>World</strong> <strong>YWCA</strong> rolls<br />

out Regional<br />

Training Institutes<br />

(RTIs)<br />

Within its leadership development<br />

and capacity<br />

building programme for<br />

the 2008-2011 period,<br />

the <strong>World</strong> <strong>YWCA</strong> is convening a series<br />

of regional training institutes (RTI)<br />

under the common theme ‘Women<br />

Creating Safe and Secure Communities’.<br />

The main goal is to contribute to<br />

the movement’s strategic framework<br />

by developing regional strategies for<br />

programme delivery including advocacy<br />

on <strong>sex</strong>ual reproductive health<br />

and rights (SRHR), HIV and violence<br />

against women (VAW).<br />

The <strong>YWCA</strong> of Trinidad and Tobago<br />

will host the Caribbean RTI; more<br />

than 50 women and young women<br />

are expected to attend. Participants<br />

will strategise on ways to eliminate<br />

violence against women and stop<br />

the spread of HIV in the Caribbean.<br />

‘Caribbean Women Creating Safe<br />

and Secure Communities: United to<br />

end Violence Against Women and the<br />

Spread of HIV’ will be the theme of the<br />

Caribbean <strong>YWCA</strong>s RTI to be held from<br />

May 24-29.<br />

The <strong>YWCA</strong> of Nigeria will host<br />

the African RTI from June 7-14 under<br />

the theme ‘African Women Creating<br />

Safe and Secure Communities’.<br />

Representatives from 28 African<br />

<strong>YWCA</strong>s and two Middle East <strong>YWCA</strong>s<br />

will attend along with three African<br />

associations working towards<br />

affiliation.<br />

In August, the Asia and Pacific<br />

RTI will be held in Bali, Indonesia<br />

from August 2-7. Hosted by the <strong>YWCA</strong><br />

of Indonesia, the RTI precedes the<br />

International Congress on AIDS in Asia<br />

Pacific (ICAAP9).<br />

A ‘Young Women Leaders<br />

Dialogue’ will feature at all RTIs,<br />

creating a safe space for young<br />

women of the <strong>YWCA</strong> movement to<br />

discuss SRHR, HIV and VAW.<br />

“RTIs are one of the long standing<br />

means within which <strong>YWCA</strong> leaders<br />

and volunteers come together at the<br />

regional level to grow their leadership<br />

and continue to offer the space for<br />

collective reflection, shared knowledge<br />

on best practices and a much-needed<br />

opportunity to affirm young women<br />

in the movement,” says <strong>World</strong> <strong>YWCA</strong><br />

General Secretary Nyaradzayi<br />

Gumbonzvanda.<br />

RTIs in Middle East, Europe and<br />

Latin America will be held in 2010.<br />

Fijian women leaders<br />

profiled on <strong>World</strong><br />

<strong>YWCA</strong> website<br />

Former <strong>World</strong> <strong>YWCA</strong> staff member Anne<br />

Walker spent 11 years with the <strong>YWCA</strong><br />

of Fiji.<br />

Fiji has become increasingly<br />

unstable after a March<br />

2009 Court of Appeal rule<br />

that declared Commodore<br />

Bainimarama’s regime illegal under<br />

the country’s 1997 constitution.<br />

Women’s groups in Fiji have called<br />

for international support and solidarity<br />

as the government’s continued clamp<br />

down on media threatened their<br />

human rights and increased insecurity<br />

in the country.<br />

The <strong>World</strong> <strong>YWCA</strong> has highlighted<br />

women’s leadership in addressing the<br />

crisis in Fiji by publishing interviews<br />

with Fijian women activists on its<br />

website. The women share their hopes<br />

and fears for the country. “Peace and<br />

security are very important to women<br />

in Fiji,“ said Leba Halofaki-Mataitini,<br />

National President of the <strong>YWCA</strong> of Fiji<br />

in her interview, “Women are one of<br />

the main groups affected by the impact<br />

of such events. As protectors and<br />

anchors of families, family security is<br />

uppermost in their minds. To a large<br />

extent, these events show the quiet<br />

strength of women.”<br />

The <strong>World</strong> <strong>YWCA</strong> promotes the<br />

United Nations Security Council<br />

Resolution 1325, which calls for<br />

women’s full participation in peace<br />

building.<br />

Read the interviews on<br />

www.worldywca.org<br />

Could your <strong>YWCA</strong> be<br />

the host of <strong>World</strong><br />

<strong>YWCA</strong> Council 2015?<br />

The <strong>World</strong> <strong>YWCA</strong> is seeking<br />

invitations from member<br />

associations to host the<br />

<strong>World</strong> <strong>YWCA</strong> Council in<br />

2015. <strong>World</strong> Council is the quadrennial<br />

membership meeting of the <strong>World</strong><br />

<strong>YWCA</strong>, involving representatives<br />

from nearly 100 member associations<br />

from around the world. The meeting<br />

is hosted by a member association<br />

and usually rotates around the world<br />

regions.<br />

Hosting <strong>World</strong> Council provides<br />

many opportunities for the host<br />

association and the <strong>YWCA</strong>s in the<br />

region. It is an opportunity to showcase<br />

the work and culture of the member<br />

association within the global <strong>YWCA</strong><br />

movement.<br />

Expressions of interest should be<br />

submitted no later than September<br />

15, 2009 in order for the <strong>World</strong> <strong>YWCA</strong><br />

Board to consider host locations at its<br />

October 2009 meeting.<br />

For further information email:<br />

worldoffice@worldywca.org<br />

www.worldywca.org


People<br />

National appointments<br />

New General Secretary:<br />

Dr. Beulah Shekhar, <strong>YWCA</strong> of India<br />

Laetitia Nakirinda Kiyingi, <strong>YWCA</strong> of Uganda<br />

Mary Small, <strong>YWCA</strong> of Gambia<br />

New President:<br />

Mayerly Georgina Rivas, <strong>YWCA</strong> of El Salvador<br />

Karen Lida Antinori de Che Leon, <strong>YWCA</strong> of Peru<br />

Matilda Johnson, <strong>YWCA</strong> of Gambia<br />

Sylvia F. Ting, <strong>YWCA</strong> of Taiwan<br />

Female condoms are the<br />

only available femaleinitiated<br />

HIV prevention<br />

technology,<br />

yet in 2007 less than<br />

26 million<br />

female condoms were<br />

distributed worldwide.<br />

Supporters<br />

Nancy Babcock (USA)<br />

Ann Drummond (Australia)<br />

Christa Gartner (Austria)<br />

Andrea Hugelshofer (Switzerland)<br />

Matsuko Ishikawa (Japan)<br />

Murielle Joye-Patry (Switzerland)<br />

Noboko Kirimura (Japan)<br />

Kaburo Kobia (Switzerland)<br />

Masako Kumae (Japan)<br />

Sheila Moyes (Great Britain)<br />

Kimiko Osato (Japan)<br />

Odette Pollien (Switzerland)<br />

Quinity BV (Netherlands)<br />

Maria Rodriguez (USA)<br />

Miyoko Takatsuki (Japan)<br />

Kayo Tsuji (Japan)<br />

Mine Watanabe (Japan)<br />

<strong>YWCA</strong> of Lebanon (Lebanon)<br />

<strong>YWCA</strong> Scotland (Great Britain)<br />

55%<br />

of<br />

young women<br />

cite condoms as an<br />

effective prevention<br />

strategy (UNAIDS)


<strong>YWCA</strong><br />

Week Without<br />

Violence<br />

October 12 – 18<br />

About the <strong>YWCA</strong> Week Without Violence<br />

The <strong>YWCA</strong> Week Without Violence is an annual campaign that takes place in the third week<br />

of October during which <strong>YWCA</strong>s around the world encourage their communities to think<br />

and act towards a world without violence. <strong>YWCA</strong>s on every continent use the week to<br />

raise awareness through events like exhibitions, readings, seminars, walks and contests.<br />

For ideas and tips for Week Without Violence activities visit www.worldywca.org.

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